| Regimental number | 868 |
| Place of birth | Clifton Queensland |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Leyburn Road, Clifton, Queensland |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Father, Neils Peter Jorgensen, Leyburn Road, Clifton, Queensland |
| Enlistment date | 15 February 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 4th Reinforcement |
| AWM Embarkation Roll number | 10/7/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A15 Star Of England on 8 April 1915 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 2nd Light Horse Regiment |
| Fate | Returned to Australia 13 March 1919 |
